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Annals of Vascular Surgery

Chao Jiang, Ni Leng, Changwei Liu, Congwei Jia, Xining Wu, Jianyi Wang, Bao Liu
Lipoma of the lower leg vein is rare, and the histopathological variant, fibrolipoma, is even rarer. Here, we report an intravascular fibrolipoma located at the junction of the deep femoral vein and the femoral vein in a 50-year-old male patient. Tumor resection and venous reconstruction with a prosthetic graft were performed. Eight months later, the patient was asymptomatic and did not exhibit swelling. To our knowledge, this is the first case report of an intravascular fibrolipoma in the literature. Lower vein venography, computed tomography venography, ultrasonography, and histologic images are presented, along with a description of the procedures employed for tumor resection and venous reconstruction...
October 17, 2016: Annals of Vascular Surgery
Gabriele Piffaretti, Stefania Ferraro, Gianpaolo Carrafiello, Edoardo Macchi, Alessandro Bacuzzi, Patrizio Castelli
Primary malignant tumors of the aorta are extremely rare, and the diagnosis is difficult from the clinical onset. Accordingly to the principles of cancer surgery, "en bloc" resection of the tumor-involved aorta and graft interposition is the gold-standard, but it is still technically challenging and co-morbidities may rule out some patients from an operative treatment. Thoracic endovascular aortic repair has been reported anecdotally but it is an ease and rapid alternative in urgent circumstances, and proved to be effective to relieve symptoms caused by these lesions...
October 1, 2016: Annals of Vascular Surgery
Kristýna Špillerová, Fausto Biancari, Nicla Settembre, Anders Albäck, Maarit Venermo
BACKGROUND: The definition of angiosome-targeted revascularization is confusing, especially when a tissue lesion affects several angiosomes. Two different definitions of direct revascularization exist in the literature. The study aim was: 1) to compare the two definitions of direct revascularization in patients with foot lesions involving more than one angiosome, and 2) to evaluate which definition better predicts clinical outcome. MATERIALS AND METHODS: This study cohort comprises 658 patients with Rutherford 5-6 foot lesions who underwent infrapopliteal endovascular or surgical revascularization between January 2010 and July 2013...
September 29, 2016: Annals of Vascular Surgery
Cynthia de Almeida Mendes, Alexandre de Arruda Martins, Marcelo Passos Teivelis, Sergio Kuzniec, Andrea Yasbek Monteiro Varella, Nelson Wolosker
BACKGROUND: Iodine contrast medium (ICM) is considered gold standard in endovascular procedures, but nephrotoxicity and hypersensitivity limit its widespread use. Carbon dioxide (CO2) is considered an alternative for endovascular procedures in patients with contraindication to ICM. However no studies have compared the outcomes of EVAR (endovascular aneurysm repair) performed with ICM or CO2 in patients with no contraindication to ICM. METHODS AND RESULTS: From May 2012 to April 2014, 36 patients with abdominal aortic aneurysms underwent EVAR in a prospective, randomized and controlled study...
September 23, 2016: Annals of Vascular Surgery
Henghui Yin, Haipeng He, Mian Wang, Zilun Li, Zuojun Hu, Chen Yao, Jinsong Wang, Shenming Wang, Guangqi Chang
BACKGROUND: To evaluate the effect of ultrasound-guided foam sclerotherapy (UGFS) in a single session combined with great saphenous vein (GSV) high ligation for severe lower extremity varicosis classified as C4 to C6, compared with GSV stripping plus multistab avulsion or transilluminated powered phlebectomy (TIPP). METHODS: From January 2012 to December 2014, 177 patients with primary GSV insufficiency, classified as C4 to C6, were randomized into the UGFS group or the control group...
September 23, 2016: Annals of Vascular Surgery
Bradford J Kim, Nakul P Valsangkar, Tiffany W Liang, Michael P Murphy, Teresa A Zimmers, Teresa M Bell, Mark G Davies, Leonidas G Koniaris
OBJECTIVE: Changing training paradigms in vascular surgery have been introduced to reduce overall training time. Herein, we sought to examine how shortened training for vascular surgeons may have influenced overall divisional academic productivity. METHODS: Faculty from the top 55 surgery departments were identified according to National Institutes of Health (NIH) funding. Academic metrics of 315 vascular surgery, 1132 general surgery, and 2,403 other surgical specialties faculty were examined using institutional websites, Scopus, and NIH Research Portfolio Online Reporting Tools from September 1, 2014 to January 31, 2015...
September 23, 2016: Annals of Vascular Surgery
Andrea Siani, Federico Accrocca, Gennaro De Vivo, Federica Mounayergi, Luca Maria Siani, Roberto Antonelli
The Ovation Abdominal Stent Graft System is a trimodular endoprosthesis planned to overcome the limitations of currently available stent grafts, allowing through complex iliac and femoral access and providing a proximal seal in challange infrarenal neck morphology. The proximal sealing is achieved by means of a network of inflatable rings filled with low-viscosity radiopaque polyethylene glycol (PEG) based polymer during stent graft deployment. The leakage of polymer outside the channel to fill the rings into the vascular system may induce an hypersensitivity reaction and anaphylactic shock...
September 23, 2016: Annals of Vascular Surgery
Kun Liu, Wen-Dong Li, Xiao-Long Du, Cheng-Long Li, Xiao-Qiang Li
OBJECTIVE: To evaluate the safety and efficacy of indirect thrombolysis via the superior mesenteric artery in patients with acute portal vein thrombosis. METHODS: Over 10 years, we studied the safety and efficacy of indirect thrombolysis via the superior mesenteric artery in 34 patients with acute portal vein thrombosis. Eighteen patients were categorized as the systemic thrombolysis group (ST) and 16 as the catheter thrombolysis group (CT). The ST group was administered low-molecular-weight heparin and patients in the CT group received catheter thrombolysis...
September 23, 2016: Annals of Vascular Surgery
Vito Cantisani, Emanuele David, Donatella Ferrari, Fabrizio Fanelli, Luca Di Marzo, Carlo Catalano, Filippo Benedetto, Domenico Spinelli, Athanasios Katsargyris, Alfredo Blandino, Giorgio Ascenti, Ferdinando D'Ambrosio
OBJECTIVE: To evaluate the diagnostic effectiveness of color-Doppler ultrasound with Superb Microvascular Imaging (SMI) compared to ultrasound with contrast agent (CEUS), CT multi-slice angiography (64 slices) and angiography required for therapeutic reasons, for follow-up after endovascular aneurysm repair (EVAR) MATERIALS AND METHODS: from March 2014 to May 2015, 57 patients treated with EVAR were evaluated with CT, CEUS, CDUS, SMI and angiography in cases requiring treatment. Evaluation included sac diameter, stent-graft integrity, identification and classification of endoleaks...
September 23, 2016: Annals of Vascular Surgery
Ludovic Canaud, Vincent Ziza, Baris Ata Ozdemir, Jean-Philippe Berthet, Charles-Henri Marty-Ané, Pierre Alric
BACKGROUND: The aim of this study was to evaluate outcomes of left subclavian artery (LSA) revascularization for hybrid aortic arch debranching. METHODS: Between 1998 and 2015, 68 patients (41 men, mean age 67+/-16 years) underwent TEVAR with LSA coverage, 19.2% (n = 13) were never revascularized and the remaining patients underwent LSA revascularization (n = 55; 80.8%) . Revascularization was achieved by LSA-carotid transposition via a medial approach in 81.8% (n = 45) and a lateral approach in 18...
September 23, 2016: Annals of Vascular Surgery
Angelina S June, Donald G Harris, Christine Yoo, Danon Garrido, Shahab Toursavadkohi, Rajabrata Sarkar, Robert S Crawford
Aortic intimal sarcomas are rare tumors that may result in distal embolic ischemia. Here we present a patient who presented with crescendo lower extremity and mesenteric ischemic events from malignant macroembolism. Management with percutaneous pharmacomechanical thromboembolectomy enabled restoration of distal perfusion and minimally invasive collection of tumor sample to confirm the suspected diagnosis of aortic sarcoma. The patient underwent definitive aortectomy and reconstruction, and is recovering well...
September 23, 2016: Annals of Vascular Surgery
Lara Reichert, Jennifer Worsham, Grant Fankhauser
Marine animal injuries are rare causes of emergency room visits and vascular injuries worldwide. Penetrating injuries from marine animals risk damage to vasculature, and physicians must be alert to such possibilities. We report a 7-year old boy with penetrating trauma and retained foreign body in the forearm from a catfish injury. Initial imaging suggested transection of the radial artery, but on exposure in a controlled setting the foreign body was found to compress the artery without any vascular injury. No vascular repair was needed after foreign body removal...
September 23, 2016: Annals of Vascular Surgery
Kun Ke, Hui Zheng, Weizhu Yang
BACKGROUND: As a novel endovascular approach to treatment, multilayer bare stent implantation remains controversial. The present study evaluated the safety and efficacy of multilayer bare stent-based endovascular treatment applied in aortic aneurysms in the reported literature. METHODS: Select articles regarding multilayer bare stent-based endovascular treatment published before and during February 2016 by searching PubMed, EMBASE, Wiley Online Library and Web of Science...
September 23, 2016: Annals of Vascular Surgery
Yuji Kanaoka, Takao Ohki, Hirotsugu Ozawa
We report a case in which a stent graft and an Amplatzer® vascular plug (AVP) were effective for the treatment of chronic aneurysmal aortic dissection. The patient was a 52-year-old man. At 45 years of age, he developed acute aortic dissection, for which he underwent surgery four times with prosthetic graft replacement in the abdominal aorta, descending thoracic, ascending aorta (without neck branch reconstruction), and thoracoabdominal aorta with the reconstruction of the celiac, superior mesenteric and bilateral renal arteries...
September 23, 2016: Annals of Vascular Surgery
A Gombert, J Grommes, G Schick, M Binnebösel, C Klink, M J Jacobs, D Kotelis
OBJECTIVE: Aortoesophageal fistulas are rare and life-threatening conditions. Till now, an association between an aortoesophageal fistula and sarcoidoisis has not been reported yet. The aim of this report is to demonstrate a case of aortoesophageal fistula (AEF) secondary to sarcoidosis and its multistage interdisciplinary surgical therapy. CASE REPORT: A 66-year-old male was diagnosed with sarcoidosis in 2014. He has been treated with glucocorticoids since then and no severe health restrictions due the disease had occurred...
September 23, 2016: Annals of Vascular Surgery
H Etienne, M Majewski, F Cochennec, L Segaux, J-P Becquemin
INTRODUCTION: Ruptured descending thoracic aneurysm (rDAA) is a rare but devastating condition. Open aortic surgery which uses cardiopulmonary bypass is associated with a high mortality. Thoracic Endovascular Aortic Repair (TEVAR) is a less invasive approach for which it remains unclear whether outcomes are superior or equivalent to open aortic surgery. In this study, we report our early and midterm outcomes with TEVAR for rDAA. METHODS: This is an observational, retrospective, single center study which included patients with rDAA and treated by TEVAR...
September 23, 2016: Annals of Vascular Surgery
Daisy Chou, Allan Tulloch, David Cossman, J Louis Cohen, Rajeev Rao, Galinos Barmparas, James Mirocha, Willis Wagner
OBJECTIVES: In selected populations, carotid endarterectomy (CEA) reduces long-term stroke risk. Studies have shown increased risk of restenosis with use of a collagen-impregnated Dacron patch compared to a PTFE patch. There is concern that collagen-impregnation may initiate thrombosis or promote restenosis due to platelet activation. We performed a retrospective analysis of our CEA experience with routine patching using knitted Dacron patches with (Hemashield) and without (Sauvage) collagen-impregnation...
September 22, 2016: Annals of Vascular Surgery
Andreja Dimic, Miroslav Markovic, Slobodan Cvetkovic, Ilijas Cinara, Igor Koncar, Lazar Davidovic
BACKGROUND: Left-sided inferior vena cava (LIVC) and duplicated inferior vena cava (DIVC) are rare asymptomatic congenital abnormalities. Unrecognized, these anomalies can be the source of major injuries and cause serious life threatening bleeding complications especially during abdominal aortic surgery. METHODS: Retrospective data for patients with two major inferior vena cava (IVC) anomalies that underwent aortic surgery over a 13-year period were collected. Patient demographics, type of aortic disease and caval anomaly, surgical approach, type of aortic reconstruction associated with procedure on caval vein, postoperative complications and in-hospital mortality were recorded...
September 22, 2016: Annals of Vascular Surgery
P Dueppers, M Duran, K Grabitz, H Schelzig
BACKGROUND: Abdominal aortic aneurysms (AAA) are a very rare in pediatric patients and can rarely be associated with tuberous sclerosis (TS). Open surgery is the first-line-therapy. We report our experience added by a review on current literature. REPORT: A 9-year old boy with TS and history of two earlier open repairs for AAA presented to our department with a recurrent juxtarenal aortic aneurysm. We performed a PTFE patch plasty. Postoperative course was uneventful...
September 22, 2016: Annals of Vascular Surgery
Antonio Eduardo Zerati, Dafne Braga Diamante Leiderman, William Gemio Jacobsen Teixeira, Douglas Kenji Narazaki, Alexandre Fogaça Cristante, Nelson Wolosker, Nelson de Luccia, Tarcísio Eloy Pessoa de Barros Filho
OBJECTIVE: To describe the endovascular treatment of late aortic erosive lesion by pedicle screw without screw removal. DESIGN: Case report. METHODS AND RESULTS: A breast cancer patient had a pathological fracture on T10, with spinal cord compression, and a pseudoaneurysm of the aorta in contact with an anterolateral pedicle screw. Endovascular surgery corrected the aortic lesion and allowed decompression, a week later, by posterior arthrodesis (T7-L1), with screw maintainance...
September 22, 2016: Annals of Vascular Surgery
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